Pharmacy Benefit Managers (PBMs) have emerged as a powerful player in healthcare today, and their role has brought value but also controversy. They have become a negative challenge for many provider practices Yet, there is a different approach that is more provider-friencly, and on this episode, we explore the approach of Alluma as an alternative to PBMs.
Moderator:Tomas Villanueva, DO, MBA, FACPE, SFHMSenior Principal, Clinical Operations and QualityVizient
Guest:Priyesh Patel, PharmD, MBAVice President and General Ma...
Pharmacy Benefit Managers (PBMs) have emerged as a powerful player in healthcare today, and their role has brought value but also controversy. They have become a negative challenge for many provider practices Yet, there is a different approach that is more provider-friencly, and on this episode, we explore the approach of Alluma as an alternative to PBMs.
Moderator:
Tomas Villanueva, DO, MBA, FACPE, SFHM
Senior Principal, Clinical Operations and Quality
Vizient
Guest:
Priyesh Patel, PharmD, MBA
Vice President and General Manager, Alluma
Vizient
Show Notes:
[00:51] Role of PBMs: value and controversy
[02:53] Alluma: a different PBM approach
[05:33] PBMs and lagging rebates: a disconnect for health plans
[06:58] Best practice: a provider-led solution
[09:27] PBMs and thwarted access to preferred medications
[10:44] A limited PBM appeals process
[11:19] Alluma’s approach: working more closely with providers
[11:40] Addressing regional prescribing patterns
[15:20] The future: more government regulation
Links | Resources:
To contact Modern Practice: modernpracticepodcast@vizientinc.com
Priyesh Patel’s email: priyesh.patel@allumaco.com
“PBM Impact on Employers & Risk to Health Systems” (Alluma white paper): Click here
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